Standard Structured Interview

Surveillance of HIV/AIDS Related Events Among Persons Not Receiving Care ("Never In Care")

OMB: 0920-0748

IC ID: 180334

Information Collection (IC) Details

View Information Collection (IC)

Standard Structured Interview
 
No Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction None Standard Structured Questionnaire for Never In Care Project Attachment 2a Structured Questionnaire.doc Yes Yes Fillable Printable

Health Public Health Monitoring

 

500 0
   
Individuals or Households
 
   100 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 500 0 0 0 0 500
Annual IC Time Burden (Hours) 250 0 0 0 0 250
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
2007 Interview Guide for Never In Care Project Attachment 3 Interview Guide.doc 05/21/2007
Consent Form for Structured Interview Attachment 5a IC for Structured Interview.doc 05/21/2007
Non-Response Data Collection Form Attachment 2c Non-Response Form.doc 05/21/2007
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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